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General NPI Number Information
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NPI Number | 1700379716
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Entity Type | Individual
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Provider Name | ANGELA JIN LIU MD
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Gender | Female
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 3509 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4105
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Country | US
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Telephone | 215-707-4009
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Fax |
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Provider Business Mailing Address
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Address Line | 313 VINE ST APT 402
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1149
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Country | US
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Telephone | 909-859-5728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MT216453
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License Number State | PA
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